Lean

Description:

The Healthy Lifestyle Program is designed for individuals who have difficulty modifying unhealthy lifestyle behaviors after being identified as having a lifestyle-influenced medical condition or risk factors of the Metabolic Syndrome.

Patient Goals:

Ð'* Enhance knowledge of, and skills necessary to manage, relevant medical conditions.

Ð'* Identify lifestyle changes necessary to improve physical health and decrease incidence and exacerbation of medical disorder.

Ð'* Learn appropriate nutrition, physical activity, and medical and mental health maintenance behaviors.

Ð'* Identify cognitive and emotional antecedents of behavioral relapse and employ adaptive coping techniques.

Ð'* Implement and regularly evaluate a prioritized behavioral plan for long-term lifestyle change.

Program Goals:

Ð'* Improve quality of life for patients by employing behavioral strategies to facilitate lifestyle modification and ultimately to reverse or effectively manage their identified medical conditions.

Ð'* Improve healthcare effectiveness by using the data from routine evaluations of patient progress and program outcomes to educate providers and refine clinical interventions.

Ð'* Improve healthcare system efficiency by reducing the utilization of available resources for treating patients' identified medical conditions.

Therapeutic Philosophy and Methods:

The Healthy Lifestyle Program is comprised of two distinct phases of treatment. Phase I is an educational component that is designed to provide knowledge that will facilitate behavioral change. Phase I teaches patients to:

i. Identify unhealthy lifestyle behaviors and understand their relationships with physiological disorder, acute and chronic pain, weight gain, impaired physical and social pursuits, and compromised cognitive and emotional functioning.

ii. Monitor and evaluate pertinent lifestyle behaviors and employ effective skills to increase the relative frequency and prioritization of healthy lifestyle behaviors.

Phase I education focuses upon nutrition, physical activity, health maintenance, and behavioral self-control; key lifestyle behaviors that influence the development and exacerbations of many medical disorders. These essential knowledge and skill sets are provided by a team of behavioral psychologists in a two-day series of group lectures and workshops.

Phase II of the Healthy Lifestyle Program is a behavioral planning, monitoring, and reinforcement component designed for patients who have difficulty implementing or sustaining healthy lifestyle behaviors. HELP Phase II interventions are based upon behavioral theories of self-control and are provided in the form of individual sessions with a health psychologist at a frequency dictated by patients' measured efforts toward modifying their lifestyles. Each session involves the evaluation of lifestyle modification efforts enacted since the previous session, and the development of a new short-term behavioral plan with associated goals to be achieved for the next scheduled session. Phase II of the Healthy Lifestyle Program also provides a regularly-scheduled support group for patients who desire to learn how similar individuals are addressing the challenges associated with implementing and maintaining healthy lifestyle behaviors.

Lifestyle modification is a gradual building process involving the establishment of new systems of innate and external reinforcement. Achieving a replicable set of healthy lifestyle behaviors is difficult because reinforcements for newly developed behaviors are not as immediately or intensely rewarding as are the reinforcements for current lifestyle behaviors. Therefore a fundamental tenet of the Healthy Lifestyle Program is that a healthy lifestyle is most effectively achieved via a reliable and methodical process of behavioral monitoring. This process increases the saliency of healthy lifestyle reinforcements and similarly increases the likelihood that healthy lifestyle behaviors will be enacted.

Maintaining new lifestyle behaviors over periods of time long enough to have positive impacts upon health is a process complicated by competing life priorities. Clinical experience indicates that many patients progress toward improved states of health in a cyclical fashion. Hence, participation in the Healthy Lifestyle Program is best conceptualized as occurring over a series of intermediate-term, time-delimited periods of clinical intervention. The Healthy Lifestyle Program reinforces behavioral progress by concentrating healthcare resources during the Ð''lifetime intervals' that patients are most likely to benefit from them; specifically, during periods when patients are actively demonstrating their readiness for lifestyle change. This inherent readiness for change may be observed in patients' overt behaviors, in terms of identifying significant health concerns and remedying them in a proactive and responsible manner:

i. Significant health concerns denote health problems that will not spontaneously resolve, may potentially worsen, or may endure for atypical lengths of time without intervention by trained healthcare professionals. Significant health concerns also refer to lifestyle behaviors that put patients at risk for developing health problems. Although all lifestyle-influenced health concerns may be targets of behavioral intervention, the Healthy Lifestyle Program prioritizes healthcare concerns that are associated with the highest rates of morbidity and mortality, including obesity, metabolic disorder, and cardiovascular disease.

ii. Proactive remediation of health concerns involves activation of the healthcare system immediately following the recognition that a relevant problem will necessitate professional healthcare, thereby improving healthcare outcomes and conserving healthcare resources. Patients demonstrate proactive health behaviors when they participate in the development and implementation of lifestyle modification plans, and the subsequent evaluation of their changing behaviors. Patients also demonstrate proactive health behaviors when they obtain information to facilitate medical judgment, and modify their schedules to facilitate healthy behaviors and timely access to healthcare services.

iii. Responsible healthcare behavior denotes conscientious participation across all stages of diagnostic and intervention regimens that by design progress from parsimonious to more complex and intensive levels of care. Responsible

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